Individual provider Active NPI

Rebecca M. Bader, OD

  • Optometrist
  • Maple Grove, MN
National Provider Identifier
1306916622
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3045 Issued in MN
Practice address
7840 Vinewood LN N
Maple Grove, MN 55369-7185
Phone
(612) 262-5000
NPI assigned
Nov 8, 2006
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3045 MN Primary

Addresses

Primary practice location

7840 Vinewood LN N
Maple Grove, MN 55369-7185

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rbader95820@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070223000255 MN Practitioner - Optometry 2860594751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 87 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jul 16, 2012 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Jul 16, 2012 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

8611 W Point Douglas Rd S
Cottage Grove, MN 55016
Phone (651) 458-1884

7840 Vinewood Ln N
Maple Grove, MN 55369
Phone (763) 236-0200

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

Interoperability endpoints

  • Direct secure messaging: rbader95820@excellian.direct.allina.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1306916622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 VINEWOOD LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697185",
            "telephone_number": "612-262-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "REBECCA",
        "middle_name": "M.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbader95820@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "7840 Vinewood Ln N",
            "city": "Maple Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553697185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.